Mr. W. H. Power's report to the local government board on diphtheria at the hospital for sick children, Great Ormond Street.

  • Power, W. H.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Mr. W. H. Power's report to the local government board on diphtheria at the hospital for sick children, Great Ormond Street. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    additional case of diphtheria. In Victoria, diphtlieria—notwith- standing treatment in that ward of several cases of throat disease and one of acute albuniinnria brought from other wards—was not followed by any illness until lapse of 14 days, when two cases of diphtheria and one of sore month occurred simultaneously. In Helena, follicular tonsillitis was not followed by infectious illness of any sort. (e.) Periods intervening between presu7ned oiJ]iortunity for contracting dijddheria and actual manifestation of the d/isease in 'particular cases.—Period not more than 6 days in Kirby, 13 days in Warner, and 14 days in Wilson. Period not less than 9 days in Cavannah, and 14 days in Robson. (/.) Apparent limitation in time of op>eration loithin the hospital of the cause of one and, another disease.—Of scarlatina: cause operative anterior to 5th March, and not after the second week of that month. Of diphtheria: cause operative anterior to 8th March, and not after (see Robson and Cavannah) 13th or 14th of March.* Of measles: cause operative in early March and not later. Of whooping cough : data uncertain. We are therefore in face of the four following considerations, and they are independent of the nature of the “ cause,” and of the means of extension of the diseases concerned :— (1.) Production of diphtheria in four out of five wards in both wings of the hospital, -within a very limited period. (2.) Production of scarlatina in two wards in one wing of the building, within nearly the same period. (3.) Many subsequent cases of diphtheria ; and during the period of their occurrence, one further case of scarlatina, one case of measles, and one case of whooping cough appearing in the wards. (4.) Cessation of production of diphtheria and of other diseases at about one and the same time. In these considerations is seen suggestion of unity of the disease-material of diphtheria with that of scarlatina; and the suggestion is not a new one. But evidently it is without practical meaning in the present connexion. For not only are measles and whooping cough diseases that have never been suspected of alliance with diphtheria, also in question, but even as regards scarlatina it is plain that distribution of two several disease-materials through one common agency must be set aside before a hypothesis of unity of disease- material could usefully be entertained. Still, I have had this suggestion in view while inquiring into the conditions of diphtheria production in the hospital. The following headings will show sufficiently the various lines upon which the inquiry has proceeded: how it has been concerned, first, with search for more direct agencies, especially for antecedent human infection ; and, the results of this proving inconclusive, how it has extended to an examination of other conditions that might be supposed capable of giving rise to or distributing the matters of infective disease. I.—Possible Causation of the Outbreak by Infection from antecedent Human Cases in the several Wards of the Hospital. The following Table (III.) shows in regard of each of the several wards the cases of infectious and doubtfully infectious illness occurring or treated in the hospital, and the method in which each case was dealt with, from the beginning of the year up to and including the outbreak. * The attack of the house physcian hy diphtheria on the 19th April is not here taken into consideration. His illness has been held to be due to infection from cases of diphtheria admitted from a distance during April.